Do no harm…One yogi's journey of health and injury in yoga
Matt Buss will be holding a workshop on Arm Balancing & Inversions, November 12, 1-2:30pm at Ahimsa Oak Park. (Click here for more information and to register.) We invited Matt to tell his story here, and we hope you enjoy reading it as much as we did!
In trying to decide what to write about here, I had to consider whether or not I have anything worth saying on the subject of yoga practice. What have I actually learned over the last 15 years that might benefit or interest anyone? At 40 years old, I am intensely aware of how little I know or understand about anything. I have zero spiritual or psychological contributions to make. I always got annoyed in yoga classes when some kid would wax philosophical about life and yoga and all the rest, and I'm ashamed to say that early in my career I was that kid (I must have been insufferable!) It does occur to me that my physical journey has revealed some valuable truths and that those might be worth sharing so others can avoid some of the setbacks I encountered. So here's a brief background of my career and a bit of advice about the practice.
In my teens and early twenties, when I still thought I would become a philosophy professor, it hadn't yet occurred to me that for every hour I spent reading or talking about my intellectual interest, I was spending 4 or 5 hours doing intensely physical activity. For me that was weight lifting, playing hacky sack, and climbing. I used to climb everything. Thinking back it feels like a different person. I had this compulsion, now thankfully absent, to climb every tree, rockface, building, radio tower, that I saw (I also enjoyed climbing bridges that spanned rivers, crawling along the I-beams underneath like a sloth).
In Troy Michigan where I lived, I had a certain tree that was probably the highest point in the city, from which I could see the Renaissance Center 30 miles away in downtown Detroit. I must have climbed that tree 200 times, and I would rush to it often to watch a pretty sunset from its tallest branches. I'd go out rock climbing a few times a week, usually alone. More than once on vacation I found myself stuck and genuinely close to falling to my death out on some rocks in Montana, having snuck onto some private ranch land because it looked like good climbing. I still have a long jagged scar on my thigh from getting caught in a rockslide that I had accidentally caused. I'm astonished at the absolute obliviousness to consequences I had as a kid. Thank god it passed.
Despite the role physicality played in my life, it hadn't occurred to me that my deepest passion was actually movement and exercise. It certainly hadn't occurred to me that I could make that my career. The few yoga classes I had taken up to that point had been at the invitation of female friends (I think this is common among guys) and though I had enjoyed them I definitely didn't have some great awakening to the power of the practice that so many folks seem to report. It wasn't until finishing college and not really knowing what I should do next that the idea of becoming a yoga teacher occurred to me. I have no idea how different my life would be now if that hadn't happened.
Luckily the circumstances of my life allowed me to really jump right in. I found a great teacher, signed up for teacher training, and started practicing daily. All my other activities fell by the wayside and I basically just practiced yoga all the time. The allure of harder postures kept me motivated to grow, and soon I was teaching classes as well as workshops on advanced postures.
When I started my career as a teacher I did what a lot of new teachers do. I found work absolutely everywhere I could. A typical week had me driving to six different towns to teach ten different classes. I was young, thought I knew a lot more than I did, and as a result, I taught a ton of mediocre classes. I'm sure some of them were good, but many were not. Not well thought out, not well-rounded, weird music, you name it. Live and learn. It wasn't until I discovered circus arts that I really learned how to teach.
After 3 years of teaching yoga, I found an aerial acrobatics studio and started the whole process over again. I trained, started teaching, and then began performing professionally. I've been doing so ever since. In my role as an aerial instructor, I'd have this human being in front of me, and they're trying to perform this task, and I have to diagnose why it isn't working for them. At first, it's anyone's guess, but over time you start to see all the pieces. The shoulder isn't rotating correctly, the hips are tilted, the grip is weak, you just see it and you fix it. Now after 12 years, I've seen every conceivable permutation, every failure mode, over and over again. I can usually anticipate which movements folks are going to struggle with before they get up in the air.
When I returned to teaching yoga after years of coaching and performing circus arts I had a much better understanding of body mechanics, and a much better eye for noticing what was and wasn't working for a given individual. I also just grew up a lot, got my butt kicked by life a few times, and returned to the practice with more empathy and a bit less ego.
I've made so many mistakes in my own practice that I like to think I can help others avoid them. For instance, when you learn how to pull your foot to your head it's normal at first to only be able to grab your big toe. You'll feel like you can pull on it as hard as you want, and you can... until you can't. I was in Natarajana, also known as Dancer Pose, when I dislocated my right big toe, and I'll never forget the feeling, and, apologies for this, the squishy sound, of those bones pulling apart from each other. Over a decade later it still aches! So I tell folks to skip the big toe, use a long sock or strap to get the bind, and wait until you can grab the long bones of your foot before pulling it to your head. And I tell them the story of my toe and we have a nice gross out laugh about it.
I like to caution teachers about heavy adjustments when students are in forward folds. Once when I was in Prasarita paddotonasana, a straight-leg seated forward fold, the woman teaching class laid over my back without warning. I had been holding my feet and pulling my nose towards my toes, and the additional weight caused my R hip to pop out of the socket. All of a sudden my entire R leg just shot back towards me (I probably could have put my nose on my toes right then!). Fortunately, as I sat up my hip slipped back into place, and beyond a few days of tenderness I was no worse for wear. Point being, the forces we put on our bodies by ourselves are usually more than enough to get the job done, and you need to be very careful adding any additional weight to a student. And for the love of god, let them know in advance!
I once saw a student get her ACL torn when the instructor grabbed her knee and pulled it over her heel. He believed that's what the pose was supposed to look like, apparently not understanding that every person's body is different and that some people's knees won't align perfectly over their heels in a lunge. I've heard dozens of stories like this over the years. Incidentally, when people ask me if taking aerial classes is dangerous, I always respond that it’s far less dangerous than taking a yoga class, because of hands-on adjustments. Honestly, I could go on and on about all the injuries I've seen yoga teachers cause with their own hands. I'm not even against adjustments, I've just seen how destructive they can be.
I have twice as many anecdotes about injuries from my circus days, but I won't go into those here. In the grand scheme of things, most of them were superficial (though I'm realizing how much of the pain of getting older is just the accumulated aches of past injuries). It's only recently that I experienced one that I would consider a crisis. After about 13 years of back bending (and doing it all wrong I now realize) I started to notice that my forward fold was becoming painful. It started gradually, but over the course of a summer, it became difficult to manage. I had constant sciatic nerve pain running down my right leg, as well as into my groin and foot. No matter what I did, stretching, resting, foam rolling, massage, meditation, the pain kept getting worse. I would go to sleep on an icepack, wake up 3 hours later in pain, switch to a hot pad, get 3 more hours of sleep, and then just get up and start my day because there was no way to get any more rest after that. I was also taking more ibuprofen than anyone should.
I got a referral for physical therapy, which after 3 months hadn't seemed to make a dent. Eventually I got an MRI and learned that one of the disks in my lumbar spine was protruding way out and compressing my sciatic nerve, and that the vertebrae above that had been pulled out of place (this is called spondylolisthesis). The surgeon I was referred to said that I actually needed two surgeries, because in addition to the slipped disk, the bones in my back didn't stack correctly, and according to him that could also be causing my pain. Luckily, he was willing to do both surgeries at the same time!
Now here's where America's broken healthcare system actually saved my butt. I was sitting in the surgeon's office feeling exhausted and desperate. I was ready to sign off on two surgeries, one of which would have installed a metal cage around two of my vertebrae (these tend to wear out and need replacing apparently) and then a miracle happened. The nurse walked in and informed me that there had been a mistake. Even though I had been referred here by my doctor, this office didn't actually accept my insurance. Sorry and have a nice day!
It probably goes without saying that I left feeling upset. In fact, I was so angry that I completely wrote off the whole surgical approach to the problem, which looking back might have been one of the best decisions of my life. Instead of having somebody cut me open and build an expensive birdcage around part of my central nervous system, I figured that maybe there was more I could do on my end to fix the problem. I decided to try and learn about my anatomy to fix the problem myself. Just because everything I had tried so far hadn't worked didn't mean that nothing else would.
First I started learning about my own anatomy and posture. It had already occurred to me that I tended to stick my butt out behind me when I was standing, and I had gotten into the habit of tucking my hips under whenever I noticed myself doing it. This enabled me to notice that I also hunch my shoulders up to my ears, which tips my head forward and makes the ground in front of me my primary visual focus. Simply tucking my hips under causes my shoulders to drop, and then my chin lifts. Then something very interesting happens. I go from staring down at the ground to looking out at the actual world!
Rumination ceases, my mood lifts, and everything feels a little more right. Not to mention that any pressure I was feeling in my lower back dissipates immediately. All of this from a simple postural adjustment. (I recently learned that this collection of postural traits is known as lower cross syndrome, and is extremely common.)
Initially, I thought if I just reminded myself over and over throughout the day eventually my posture would correct itself. But even after a couple of years of actively tucking my hips dozens of times a day I would still notice my butt was out, my shoulders were hunched up and my gaze was at the ground six feet in front of me. What I would later learn is there are underlying structural issues that a person can't just will their way out of.
Now although I have no medical training, (I spend most of my professional time teaching people to wrap themselves up in fabric and tumble down in pretty shapes) with all the injuries I've seen and sustained myself, I believe those of us in the yoga world could benefit from the medical school dictum “First do no harm.” When I reflect, it seems that all the injuries I'm aware of were caused by ignorance or arrogance. We could probably all benefit from a bit more familiarity with muscular anatomy. What follows is my current, still very limited, understanding of the facts surrounding lower back posture that were relevant to my back problems.
Our hips (and all the other bones in our body) have muscular forces acting on them from different directions. On the front of our bodies, the hip flexors (which are actually 5 different muscles) pull our hips down and our abdominal muscles pull them up (at least they're supposed to). In back, our glutes pull down on the hips and our lower back muscles pull up. In lower cross syndrome, hip flexors that are overactive pull the front of our hips down, while a lengthened and weakened core fails to pull them up into balance. In the rear, lower back muscles that are tight and overactive pull the hips up (pulling the butt out), and the lengthened and under-active glutes fail to compensate with a downward force. Due to weakness in the core and butt, and tightness in the hips and lower back, our hips are chronically tilted forward. This puts a strain on our lower backs leading to pain and dysfunction.
The solution is straightforward. Strengthen your butt and core, stretch your hip flexors and lower back. Once I learned this stuff (funny how none of the doctors, surgeons, or physical therapists I saw ever told me about it) I started a strength training regimen aimed at correcting the issues. A few months in my pain began to diminish. A year in I was pain-free. I've actually lost significant flexibility in my hips and legs, but I've made them far stronger. For most of my yoga career, I drilled my splits and foot behind-the-head postures while avoiding strengthening postures like lunges. As a result, I had very bendy, and very scrawny legs.
When it comes to back bending in general, I spent the bulk of my career basically just cranking on my lower back, without doing anything to protect it. I wasn't tucking my hips under, and I wasn't engaging my glutes, both of which protect your lower spine. I also wasn't aware of the local muscles of the core that exist to protect our lower vertebrae and keep the disks in place. If I had known then what I know now, it’s conceivable that my back issues never would have presented in the first place.
Here is what I now understand, and what I make sure I explain in every class I teach. Engaging our glutes and extending our hips (tucking under) while back bending protects our spine. Strengthening our local core muscles by doing things like side plank and drawing our belly button to our spine while using our abs also protects our spine.
These techniques are simple to employ, and I believe everyone who teaches a physical discipline should be familiar with them. Yoga instructors, who assist people in exploring their complete range of motion, absolutely need to be aware of them. I wish that I had been exposed to these ideas earlier in my career.
It's been over a year since I discovered these concepts and started putting them into action in my own practice. The 2 main changes I made were adding weighted squats to strengthen my butt and legs, and strenuous ab workouts to strengthen my core (I encourage everyone to look up Unicycle Abs on youtube) Though its certainly possible to strengthen your legs using bodyweight and traditional yoga postures, I choose to use weights. These two simple elements have significantly improved my posture and completely resolved the back pain. I also focus on stretching my hip flexors and lower back without sticking my butt out in order to keep those muscles from pulling my hips out of alignment. I suspect many people could benefit from doing the same.
At this point in my life, a decade and a half into my yoga practice, semi-retired from performing circus arts, and finally feeling like I at least sort-of understand the human body and it's limitations, I'm excited to dive back in to teaching yoga. It feels like I have something to offer now that I didn't in the past. There are poses I used to do that are off the table for me now (Thankfully I have pictures!), but in general I feel better than I ever have. If I'm able to help even a few people practice in a safer and more sustainable way I'll be happy. Thanks for taking the time to read this, and I look forward to seeing you on the mat!
Matt Buss will be holding a workshop on Arm Balancing & Inversions, November 12, 1-2:30pm at Ahimsa Oak Park. Click here for more information and to register.
